1-2026-2027 METRO Stop Loss RFP Workbook .pdf
PDF 149 KB Posted
- Solicitation number
- 2026000008
- Issued by
- Harris County, Houston City, Texas
About this file
This is a Stop Loss Insurance Request for Proposal workbook for the Metropolitan Transit Authority of Harris County (METRO) in Texas. METRO seeks stop loss insurance coverage for both non-union and union employee populations, with proposals due June 16, 2026, for an effective date of October 1, 2026. Proposers must submit intent to quote to proceed with receiving detailed plan documents, historical data, and census reports. The RFP requires quotes for a 24/12 contract structure and specifically mandates two proposal options: a standalone quote for the existing non-union population currently covered under Cigna's individual stop loss (ISL) at $275,000, and a combined quote including both non-union and newly transitioned union populations. All pricing quotes must be firm for 60 days to allow adequate time for METRO board approval.
Current stop loss coverage is provided by Voya and Cigna with an ISL premium of $160.69 per employee per month (PEPM) and an aggregate stop loss (ASL) premium of $130.57 PEPM for 2024-2025. Proposers must quote the current $275,000 deductible as well as alternative options at $300,000 and $325,000, with all quotes submitted net of commissions. The RFP specifically requires a no-laser option with a 50% renewal rate cap and mandates inclusion of Spec Advance Funding with confirmation that the AAW requirement is waived. Non-union employees include approximately 4,789 regular full-time employees working at least 30 hours weekly, while union employees working at least 40 hours weekly are also eligible. Medical and Rx administration will remain with Cigna/OptumRx through 2026-2027. Any mention of renewal language or renewal dates in proposals is strictly prohibited per the 10.1.26 agreement requirements, with failure to comply resulting in potential disqualification.
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Other files
| File | Type | Posted |
|---|---|---|
| 2-METRO Stop Loss RFP Scope of Work FY2027 Final.pdf |
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Text version
Proposed Effective Date:
Proposal Distribution Date:
Proposal Due Date:
Name:
Address:
City, State, Zip:
Description:
SIC Code:
Active Employees:
Retirees:
Dependent Children:
Active Employees:
Retirees:
Dependent Children:
Primary Contact:
Phone / Email Address:
Secondary Contact:
Phone / Email Address:
Consultant/Producer:
50% 45% 45%
2025-2026
$250,000
$130.57 $152.27 24/12 24/12
N/A N/A N/A
4 Please quote a FIRM contract or note any restrictions or updated information needed to FIRM quote at a later date.
6 Please note any LASERED members and adjusted deductible applicable.
9 Please include Spec Advance Funding in your proposal and confirm AAW requirement is waived.
As a reminder, we will include in the client's marketing analysis the blanket statement provided by your corporate office in response to whether the employer’s plan document, included in this RFP, will be used for claims determination purposes. Please let me know if you have any questions regarding this statement.
RFP Marketing Contacts (Gallagher Benefit Services, Inc.)
Please be advised that any mention of renewal language or renewal date(s) is strictly prohibited in the 10.1.26 agreement between the winning proposer and METRO. Proposers are required to adhere to this stipulation to ensure compliance with METRO's contractual guidelines. Failure to comply may result in disqualification from the bidding process.
5 To ensure adequate time for METRO's board approval of the winning proposer, all pricing quotes received must be firm for (60) day(s).
RFP Marketing Objectives
Renewal Rate Cap Included?
Proposal Effective Date / Due Date
Client's Name and Address
Much effort has been made to provide all necessary and accurate information in this Request for Proposal. It is the sole responsibility of the proposers to ensure that they have all information necessary to complete submission of their proposals. If more information is needed, contact your Gallagher Benefit Services representative.
(832) 477-5201 Nick_Vartabedian@ajg.com Joe Sarabia Account Coordinator
(713) 358-5772 Joe_Sarabia@ajg.com Annie Bridges
8 ALL quotes must also include a no laser option WITH a 50% renewal rate cap.
Nick Vartabedian Account Manager
2 Provide a quote matching their current specific stop loss policy ($275K ISL) as well as $300K and $325K.
Metropolitan Transit Authority of Harris County
3 Please quote a 24/12 contract.
7 Please quote net of commissions.
Stop Loss Request for Proposal
October 1, 2026 May 17, 2026 June 16, 2026
Metropolitan Transit Authority of Harris County 1900 Main Street Houston, TX 77002
Transportation Services
Regular, full-time non-union employees working at least 30 hours per week, and employees receiving LTD benefits.
1 Quote should include Medical and Rx
PAID
$160.69ISL Premium (PEPM)
ASL Premium (PEPM)
Pre-65 retirees and grandfathered retirees are included in ISL/Agg coverage.
Post-65 retirees are excluded from coverage.
Up to age 26, including any child for whom they are legal guardian
Year
Specific Deductible $275,000 $275,000 Carrier Voya Cigna Cigna
2023-2024 2024-2025
- Medical/Rx administration is currently under contract with Cigna/OptumRx and will remain under contract for 2026-2027.
- No plan design changes have been finalized for 2026-2027. As decisions become finalized, we will provide updates to the market.
Contract Type (e.g. Paid, 12/12, 12/15, 15/12)
Please submit your intent to quote to Nick Vartabedian and Joe Sarabia at Gallagher. Plan documents, historical data, and Census reports will be shared via secure email once an intent to quote has been received.
Type of Industry
Non-Union Employee Eligibility Provisions
Information / Executive Summary
Stop Loss History
Union Employee Eligibility Provisions Regular, full-time union employees working at least 40 hours per week.
Retirees and Surviving spouses are eligible for Medical coverage. Once classified as a Retiree or Surviving spouse, if coverage is terminated they will not be eligible for coverage at any future date.
Up to age 26, including any child for whom they are legal guardian
- METRO has a large Union population that is considering moving to a self-funded medical plan with Cigna for the 2026-2027 plan year.
Currently the group is fully-insured with Cigna. As part of the RFP process, we will be requesting a quote option that includes coverage of this group. Proposers who submit an intent to bid will be provided with the corresponding plan documents, historical data, and census reports for the METRO Union.
- Please provide 2 proposal options as part of your RFP response: (1) A standalone quote for the Non-Union population that has current ISL coverage through Cigna, and (2) a combined quote for both the Non-Union population and the newly brought on Union population.
mailto:Nick_Vartabedian@ajg.com mailto:Nick_Vartabedian@ajg.com mailto:Nick_Vartabedian@ajg.com mailto:Joe_Sarabia@ajg.com mailto:Joe_Sarabia@ajg.com mailto:Joe_Sarabia@ajg.com mailto:Nick_Vartabedian@ajg.com mailto:Joe_Sarabia@ajg.com
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